Individual
JESSIKA LEIGH BEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
845 W 56TH ST, SAN BERNARDINO, CA 92407-5301
(909) 205-3191
Mailing address
845 W 56TH ST, SAN BERNARDINO, CA 92407-5301
(909) 205-3191
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN206253
CA
Other
Enumeration date
12/02/2010
Last updated
12/02/2010
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